Nutrition education remains insufficient in many health professional training programs despite the central role of diet in the prevention and management of chronic disease. Contemporary nutrition science increasingly rec...Nutrition education remains insufficient in many health professional training programs despite the central role of diet in the prevention and management of chronic disease. Contemporary nutrition science increasingly recognizes that dietary behaviors and health outcomes are shaped by complex interactions among biological, behavioral, environmental, and food system factors. This perspective proposes an interdisciplinary framework for nutrition education that integrates the complementary expertise of physicians, dietitians, chefs, and farmers. By bridging clinical care, nutrition science, culinary practice, and agricultural systems, such an approach may strengthen the translation of evidence into practice, improve nutrition-related competencies among health professionals, and ultimately enhance population health outcomes.
BACKGROUND: The ability of hostility and Type-A personality to predict cardiovascular outcomes makes understanding antecedents of these personality traits an important public health objective. OBJECTIVE: We examined whet...BACKGROUND: The ability of hostility and Type-A personality to predict cardiovascular outcomes makes understanding antecedents of these personality traits an important public health objective. OBJECTIVE: We examined whether blood-measured fatty acids (the exposure) are associated with hostility and Type-A personality (the outcome), while accounting for lifestyle, sociodemographic factors and polygenic background. METHODS: Personality traits, sociodemographic and lifestyle data were obtained in 1992-93 from 452 family members living in kibbutz settlements in Israel (Visit 1) and re-measured 8-10 years later in 379 individuals (Visit 2). Red blood cell fatty acid levels were determined in Visit 1 by gas chromatography. Longitudinal associations of Visit 1 fatty acids with Visit 2 personality traits were examined using linear models, before and after controlling for baseline personality scores. The contribution of the environmental factors to personality scores beyond heritability was estimated by variance decomposition. RESULTS: In longitudinal analysis, 1% increase in Visit 1 Total n-6 fatty acid was associated with a 0.328-unit decrease in Visit 2 Type-A score (95% confidence interval (CI): -0.571, -0.085). After adjustment for baseline personality levels, the association was slightly attenuated (β=-0.204; CI: -0.399, -0.009). One-percent higher Total n-6 was also associated with 1.119 units lower Visit 2 hostility score (CI: -2.777, 0.038; p=0.055). Finally, independent of the genetic contribution (32%-38% of adjusted variability in hostility and Type-A personality), a 1% increase in Total n-3 and Total n-6 was associated with 2.539 (CI: -3.907, -1.171) and 0.201 (CI: -0.365, -0.037) unit lower hostility and Type-A scores, respectively. CONCLUSIONS: Higher RBC Total n-6 fatty acid levels were associated with lower Type-A personality scores. After adjustment for baseline personality levels, the associations between Total n-6 and hostility and between Total n-3 and hostility were attenuated. These findings support further investigation of the relationship between fatty acid biology and personality traits using study designs better suited to causal inference.
BACKGROUND: The translocation into the systemic circulation of proinflammatory bacterial components such as lipopolysaccharide (LPS) has been linked to cardiovascular disease (CVD). OBJECTIVES: We aimed to evaluate the a...BACKGROUND: The translocation into the systemic circulation of proinflammatory bacterial components such as lipopolysaccharide (LPS) has been linked to cardiovascular disease (CVD). OBJECTIVES: We aimed to evaluate the association between baseline postprandial endotoxemia and the risk of suffering major adverse cardiovascular events (MACE) in patients with coronary heart disease (CHD), as well as the influence of consuming a low-fat (LF) diet or the Mediterranean (MED) diet on the associated risk. METHODS: Our research was conducted within the framework of the CORDIOPREV Study, a clinical trial which involved 1002 patients with CHD randomly assigned to consume an LF diet or the MED diet for 7 y. A mixed meal was administered at the beginning of the study and after 3 y of follow-up. LPS plasma concentrations were measured by Limulus Amebocyte Lysate (LAL) colorimetric assay and gut microbiota was analyzed using 16S metagenomics. RESULTS: Baseline postprandial increase in LPS plasma concentrations were associated with recurrence of MACE after a follow-up of 7 y, using Cox regression analysis [hazard ratio (HR):1.42 (1.01, 2.00)]. Patients with moderate LPS postprandial increase and consuming LF diet had higher risk of suffering MACE compared with the MED diet [HR: 1.45 (1.01, 2.09)]. Both diets reduced LPS plasma concentrations and formed a gut microbiota profile associated with a postprandial LPS decrease. CONCLUSIONS: Our results suggest that the magnitude of postprandial endotoxemia is associated with suffering new MACE in patients with CHD, with the MED diet exercising a higher preventive role than an LF diet. Our results especially are relevant to clinical practice, supporting the measurement of postprandial endotoxemia as a tool for personalized medicine in secondary prevention. This study was registered at clinicaltrials.gov as NCT00924937.
Members of Food and Agriculture Organization and the International Atomic Energy Agency (IAEA) have recently stated that it is time for an update of human energy requirements (ERs) and expressed concerns about previous m...Members of Food and Agriculture Organization and the International Atomic Energy Agency (IAEA) have recently stated that it is time for an update of human energy requirements (ERs) and expressed concerns about previous methodologies used in their derivation. They suggest that a factorial approach to energy expenditure and requirements, which includes an estimate of physical activity energy expenditure (PAEE), is no longer needed. Instead, they propose that predictive equations for daily total energy expenditure (TEE) derived from an IAEA large database of doubly labeled water (DLW) measurements of TEE can be used to estimate population ERs from basic anthropometric data for most population groups. Even though predictive equations cannot account for variable PAEE, they argue that ecological DLW studies have demonstrated that the TEE of presumed physically active population groups, i.e., hunter gatherers and rural Nigerian females, did not reflect an active lifestyle compared with United States and European populations. Such reports have resulted in the suggestion that TEE is a relatively constrained product of our evolved physiology. It is argued that we adapt to maintain TEE within a narrow physiological range rather than increasing with physical activity in an additive, dose-dependent manner as is implicit in the factorial model. Here, the factorial model is re-examined. Weight-adjusted metrics of PAEE are derived, which are used to analyze published energy expenditure of traditional populations and compare it with a large DLW data set, assembled to derive the United Kingdom energy dietary reference values. This reveals very high rates of energy expenditure consistent with lifestyles with no obvious evidence of energy constraint. We conclude that any approach to updating human ERs will need to address the interindividual variation in PAEE.
BACKGROUND: Adult-attained height is associated with later-life health, but it reflects both genetic and non-genetic influences. The health implications of height variation not explained by known common height-associated...BACKGROUND: Adult-attained height is associated with later-life health, but it reflects both genetic and non-genetic influences. The health implications of height variation not explained by known common height-associated genetic variants remain unclear. OBJECTIVE: To examine associations of residual height (height variation independent of known genetic variants) with multiple disease incidence and all-cause mortality in later life. METHODS: In this cohort study of 407,366 adults of European ancestry (aged 40-70) in UK Biobank (2006-2010), sex- and age-specific genetically predicted height was estimated from 9,863 height-associated variants, adjusted for 30 principal components of ancestry. Residual height was calculated as the difference between observed and genetically predicted height. Plasma proteomics (2,054 proteins; Olink Explore) were profiled. Deaths and 49 incident diseases were ascertained through national registries. Multivariable Cox models estimated associations of residual height and related proteins with disease incidence and mortality. RESULTS: Higher residual height (mean [SD], 0.0 [4.8]) was associated with more favorable self-reported pre-adulthood exposures (e.g., later birth years, no maternal smoking around birth, being breastfed as a baby, no adoption experience, and lower childhood adversity scores) and lower hazard ratios of 32 out of 49 diseases (median follow-up=∼12.5 years). Using participants with residual height within ±0.5 SDs from the mean as reference, those with residual height <-2 SDs had higher adjusted hazard ratios of mortality (1.61; 95% confidence interval 1.50, 1.72), multimorbidity (1.28; 1.12, 1.46), cardiovascular disease (1.45; 1.32, 1.60), psychiatric/neurological disease (1.38; 1.28, 1.48), and other disease categories (e.g., diabetes, digestive, and musculoskeletal diseases). In contrast, higher genetically predicted height was associated with higher incidence of 19 diseases, including subtypes of cancer, non-atherosclerotic cardiovascular diseases, and musculoskeletal diseases, as well as higher all-cause mortality. We identified 806 plasma proteins related to inflammation, immune response, and autophagy via TNF, NF-κB, PI3K-Akt, and JAK-STAT signaling pathways, which were associated with residual height and multiple diseases and mortality. CONCLUSION: Higher residual height was associated with lower disease incidence and mortality, with associations distinct from those for genetically predicted height.
BACKGROUND: The effect of long-term daily multivitamin-mineral (MVM) supplementation on Coronavirus Disease 2019 (COVID-19) prevention and symptom severity remains unclear. OBJECTIVES: We tested the hypothesis that a dai...BACKGROUND: The effect of long-term daily multivitamin-mineral (MVM) supplementation on Coronavirus Disease 2019 (COVID-19) prevention and symptom severity remains unclear. OBJECTIVES: We tested the hypothesis that a daily MVM reduced COVID-19 incidence or symptom severity among generally healthy older adults. METHODS: We conducted a secondary analysis in the COcoa Supplement and Multivitamin Outcomes Study, a randomized, double-blinded, placebo-controlled trial (June 2015 to December 2020), evaluating daily MVM and cocoa extract supplementation for the prevention of cardiovascular disease and cancer among 21,442 United States adults. The primary outcome was incident COVID-19 between 1 January, 2020 and 31 December, 2020, defined as the first occurrence of a self-reported positive test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, a physician's diagnosis, hospitalization, or death due to COVID-19. The prespecified secondary outcomes were symptomatic COVID-19 and symptom count among nonfatal cases through 31 August, 2020, when detailed symptoms were collected. We conducted intention-to-treat (primary) and per-protocol (secondary) analyses among consistently adherent participants. RESULTS: The final year of the COcoa Supplement and Multivitamin Outcomes Study intervention phase from January 2020 to December 2020 coincided with the start of the COVID-19 pandemic. Of the 18,205 participants who remained in the trial and were adherent to study pills as of 1 January, 2020, 382 were randomly assigned to MVM and 404 to MVM placebo (no MVM) and reported a COVID-19 infection through 31 December, 2020. In intention-to-treat analysis, the hazard ratio for MVM compared with placebo was 0.93 for COVID-19 incidence [95% confidence interval (CI): 0.81, 1.07]. Among the 338 cases with detailed symptom data, the odds ratio for symptomatic COVID-19 comparing MVM with placebo was 0.70 (95% CI: 0.44, 1.11). In per-protocol analyses, among participants compliant with study pills during 2020, the odds ratio for symptomatic COVID-19 was 0.60 (95% CI: 0.37, 0.99). CONCLUSIONS: A daily MVM supplement, compared with placebo, does not significantly reduce COVID-19 incidence among older adults but shows a promising signal lowering the odds of symptomatic COVID-19 illness. The Cocoa Supplement and Multivitamin Outcomes Study was registered at clinicaltrials.gov as NCT02422745.
Ottino-González J, Adise S, Descarpentrie A
… +8 more, Esaian S, Marquess KM, Paudel D, Li H, Alderete TL, Bansal R, Peterson BS, Goran MI
Am J Clin Nutr
· 2026 Jun · PMID 42373346
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BACKGROUND: Diet quality during early life may influence neurodevelopmental trajectories, but the associations between ultra-processed food (UPF) intake and neurocognitive outcomes has not been broadly examined. OBJECTIV...BACKGROUND: Diet quality during early life may influence neurodevelopmental trajectories, but the associations between ultra-processed food (UPF) intake and neurocognitive outcomes has not been broadly examined. OBJECTIVE: To examine whether cumulative UPF intake from infancy through early childhood is associated with cognitive performance at 24 and 72 months and with subcortical brain volumes at 72 months. METHODS: In this prospective birth cohort study, multiple 24-hour dietary assessments were used to calculate the percentage of UPF-calorie intake, using the Nova classification system. Cumulative UPF intake from 6 to 24 and from 6 to 72 months was summarized as the area under the curve. Cognitive performance was assessed at 24 and 72 months, and subcortical brain volumes were derived from T1-weighted MRI scans at 72 months. Associations were examined using multiple univariate linear regressions with false discovery rate (FDR) correction. RESULTS: Cumulative UPF intake was not associated with cognitive performance at either 24 months (n=144, 57% girls) or 72 months (n=93, 59% girls). In contrast, cumulative UPF intake from 6 to 72 months (n=79, 58% girls) was inversely associated with the volumes of the bilateral accumbens, left amygdala, bilateral pallidum, left putamen, and bilateral thalamus (all FDR-adjusted p < 0.05). On average, a 10% higher proportion of cumulative UPF intake was associated with a 1.92% lower subcortical volume (CI95% -3.29, -0.58). Associations were consistent across exposure windows (6-24 months compared with 72 months) and UPF subtypes (e.g., snacks, fast food). CONCLUSIONS: Greater cumulative UPF intake from infancy through early childhood was associated with differences in neurodevelopment at age six years. These findings highlight this period as a potentially relevant window for nutrition-focused prevention efforts. Future studies are needed to clarify specific windows, neurobiological mechanisms, identify specific nutritional factors, and define long-term implications.